- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.13 / $2,240.00 / $7,629.00
| Facility | | $41.13 | $2,240.00 | $7,629.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.06 / $37.03 / $48.71
| Professional | | $30.06 | $37.03 | $48.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,299.82 / $2,746.00 / $13,822.74
| Facility | | $2,299.82 | $2,746.00 | $13,822.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.46 / $38.86 / $58.86
| Professional | | $37.46 | $38.86 | $58.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.00 / $678.00 / $678.00
| Facility | | $678.00 | $678.00 | $678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.22 / $40.15 / $66.78
| Professional | | $29.22 | $40.15 | $66.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.18 / $45.18 / $58.26
| Professional | | $45.18 | $45.18 | $58.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.72 / $41.57 / $42.82
| Professional | | $36.72 | $41.57 | $42.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.00 / $2,371.00 / $8,017.00
| Facility | | $617.00 | $2,371.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.19 / $38.31 / $641.00
| Professional | | $31.19 | $38.31 | $641.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $5.00 / $97.20
| Professional | | $5.00 | $5.00 | $97.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.00 / $678.00 / $678.00
| Facility | | $678.00 | $678.00 | $678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.54 / $39.54 / $63.42
| Professional | | $28.54 | $39.54 | $63.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.43 / $34.65 / $40.72
| Facility | | $31.43 | $34.65 | $40.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.33 / $36.07 / $40.72
| Professional | | $31.33 | $36.07 | $40.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,884.00 / $6,000.00
| Facility | | $1,334.00 | $2,884.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.04 / $44.48 / $73.84
| Professional | | $36.04 | $44.48 | $73.84 |